Citalopram, can I alternate doses?

[Alexaplaykatebush]

Hi all, hope somebody can advise me.
I've gone back on citalopram 10mg about 3weeks ago, I was in a pretty bad way by the time I plucked up the courage to go back on them and they've definitely helped my anxiety.
I had a review with the nurse yesterday and she has advised me to increase to 20 as my progress and improvement seemed to have come to a plateau, I'm definitely less anxious and less physical symptoms of anxiety, I'm not self harming now although I'm still thinking about doing it sometimes.
I feel sort of flat, I'm not sure if this is mild depression or just feels flat compared to being in constant fight or flight mode?
My question is can I take 10mg one day then alternate 20 the next?
Or is is better to cut them and take 15mg every day or just go for the 20?
I'm wary of side effects as I did feel very groggy and dopey the first 10days or so and still have nausea now.
I also don't want to feel numb or spaced out but I do want to feel better than I do now.
Any suggestions would be appreciated tia.

I would just go for the 20mg. You've only been on them 3 weeks, side effects can take awhile to go. Taking alternate doses is more likely to give you worse side effects as your body will be getting different amounts and won't be able to adjust as easily.

I've been on 20mg citalopram for years, I went to see the GP recently as I wasn't feeling great any more and he said 20mg is quite a low dose (he put mine up to 30mg), so 10mg is tiny and probably won't do enough for you long term.

I’d do as the Nurse said they can tell how we are with what we say and don’t say! I went from 10mg of Mirazapine to 45mg over a 2 month period and been on 45 for almost a year. I have them because my sleep was utterly crap, work was beyond stressful.

but I am well aware that my sleep is better and work is ok because I’m on ADs - I have a long way to go but I’m just glad I I asked for help and took the GPs advice. I honestly wouldn’t be here if I hadn’t. It was hard to say I need help and put myself in the hands of a medical professional.

Thank you for replying, I think just going for the 20 might be the right thing, doctor's orders and saves faffing about cutting pills and losing track.
Major symptom of my anxiety is having to overthink about everything from a hundred different angles, what if what if what if.
I'm wary of increasing because 10 has been enough when I've been on them twice in the past, in hindsight I came off them too soon, partly because they did work so well I thought I was better.
I've never felt the need to increase before so that's quite scary, I feel like every time I get sick I become weaker, less resilient, no offence to anybody I know this is an unhealthy way to think about mental illness.

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I was at work when I spoke to the nurse on the phone, I did tell her I felt better but was feeling flat and that I was worried about side effects. The first appointment I was a blubbering mess, so she could probably tell I was better.
I didn't mention the self harm, it's not something I've done before, not so directly anyway if that makes sense.
I just wish I could be normal, I'm worried increasing will make me dopey or zombified and I'll just end up weird in a different way.

Increasing won't make you "zombified". It's a common misconception that antidepressants make you numb or turn you into a zombie but it's really not true. 10mg is a starter dose, it's what they put you on to get you started but you're supposed to go higher than that as it doesn't do enough for most people. You are definitely overthinking this, which shows you probably do need the higher dose. Don't see it as a negative thing, it will make you feel better!

You say you wish you could be 'normal' but so many people take antidepressants now that it is actually quite normal to take them. And there's no shame in it.

And worst comes to worst if you increase the dose and don't like how you feel, you can just go back down to 10mg again.

I went up to 15mg for about a week but tbh I had the side effects anyway and I thought it I’m going to feel like this for ANOTHER few weeks after taking the extra 5mg I’d rather just get it over and done with so I then just moved up to 20. What are the side effects you suffer the most with OP? Mine was increased anxiety and the GP gave me propranolol to take alongside (which I only take when I feel like I really need to) which completely alleviates the physical symptoms of anxiety 💐

Sorry to jump on this.
Recently tried propanol for anxiety, but it caused insomnia and strange tingling in my muscles.
Doctor has now suggested I try citalopram - does it cause weight gain?

Thanks all for the replies, I'm picking my new prescription up tomorrow and I'm going to take the 20 as they are.
Side effects have mostly been nausea/funny tummy, gurning and teeth grinding and I was feeling very sleepy and slow at first but that's improved now.
I did think about asking for propranolol to take along side at the first appointment because I was in a bad state but the citalopram has worked really well at reducing the worst of the physical symptoms I was having, panic, weight on my chest, sweating and tinnitus.
I'm still overthinking and worrying a lot, hopefully the increase will help with that and I'll feel better before too long.

I was on 10mg for many years until my mum became terminally I’ll. I upped to 20mg and was able to go back to 10mg after a year or so. The last few years I have struggled without any meds. I’m now on 30mg and regret not taking the dosage as advised by the dr months ago. Good luck with everything, anxiety/overthinking is a terrible thing. 🤗

I also found the slow release beta-blockers helped a lot.